Acute methanol poisoning in Tunisia: clinical features, biological and associated factors for mortality.

BACKGROUND: Acute Methanol Poisoning (MP) is rare but potentially serious. OBJECTIVES: To study the clinical and biological characteristics of acute MP and its associated factors of mortality. METHODS: We conducted a cross-sectional study including case series of MP which took place in Kairouan, Tunisia. Cases started consulting the emergency room on a festive day (1st day of Eid al- Fitr) corresponding to May 24, 2020. RESULTS: We included 65 male victims of MP. The median [interquartile] age was 28.0 [21.0 - 35.0] years with extremes ranging from 17 to 75 years. The median [interquartile] time between the ingestion of methanol and the medical consultation was 48.0 [24.0 - 50.0] hours. On admission, the majority of patients described neurological (98.4%) and gastrointestinal symptoms (51.4%). Four patients remained visually impaired and 8 patients (12.3%) had died. The univariate analysis reported an association between mortality and age, amount of methanol ingested, co-ingestion of cannabis, delay to consultation, neurological distress, seizures, lower systolic and diastolic blood pressure, metabolic acidosis, lower levels of potassium, higher levels of sodium, hematocrit, glycemia, creatinine, anion gap, and high Acute Physiology and Chronic Health Evaluation II score. CONCLUSION: Mortality rate following MP was high and was associated with several factors.

Compassion fatigue among frontline healthcare workers during the covid-19 pandemic in Tunisia.

BACKGROUND: Healthcare workers (HCWs) are highly vulnerable to compassion fatigue (CF), which not only leads to decreased mental and physical health, but also to deterioration in the safety of care delivered. Our study aims to measure compassion satisfaction (CS), CF levels and their predictors among Tunisian HCWs. METHODS: We conducted a cross-sectional study among HCWs caring for confirmed and suspected Covid-19 patients, staff at two university hospitals in Sousse, Tunisia during the 4thwave of coronavirus through a self-administrated Questionnaire, using the French version of the Professional Quality of Life scale ProQol, version 5. RESULTS: A total of 274 professionals were recruited with a mean age of 32.87±8.35 years. HCWs tend to have an overall moderate levels of compassion satisfaction, secondary traumatic stress and burnout with mean scores 35.09±7.08, 29.72±7.62, 28.54±5.44 respectively. Self-reported resilience (ß = 0.14, p = 10-3), work engagement (ß = 0.39, p = 10-3) and burnout (ß = -0.32, p = 10-3) were the predictors of compassion satisfaction in the linear regression analysis (adjusted r2 = 0.45). Similarly, limited work experience, compassion satisfaction and secondary traumatic sub-scores were the determinants of burnout (ß = -0.1, p = 0.04; ß = -0.54, p = 10-3; ß = 0.35, p = 10-3 respectively); (adjusted r2 = 0.48). Regarding STS, female professionals (ß = 0.20, p = 10-3), being married (ß = 0.19, p = 10-3), the fear of transmitting the infection (ß = 0.11, p = 0.03) and burnout (ß = 0.39, p = 10-3) were the predictors for the occurrence of secondary traumatic stress (adjusted r2 = 0.48). CONCLUSION: More resilience promoting interventions and more coping skills programs must be implemented to fulfill HCWs' psychological well-being needs.

Patient safety in medical education: Tunisian students' attitudes.

Health care delivery continues to be unsafe despite major patient safety (PS) improvement efforts over the past decade. Medical school education plays an important role in promoting this culture during initial training. To determine undergraduate medical students' attitudes toward PS at a Tunisian medical school. We carried out a cross-sectional study among undergraduate medical students at Ibn Al Jazzar Medical School in Sousse, Tunisia, using a self-administered questionnaire inspired from the valid tool: Attitudes to Patient Safety Questionnaire (APSQ III). A total of 178 medical students responded to the questionnaire. Medical students tend to have an overall positive perceptions of PS culture with a global mean score 5.33 ± 0.5. Among the individual domains 'Working hours as a cause of error' earned the highest score (6.38 ± 1.0) followed in order by 'Team functioning' (6.24 ± 0.8), 'Error inevitability' (5.91 ± 1.0) and 'Patient involvement in reducing error' (5.50 ± 1.0). The lowest score was for 'Professional incompetence as a cause of error' (4.01 ± 1.0). A PS domain's mean scores comparison based on socio-demographic variables: gender, age, academic year and on PS training revealed a statistically significant difference (p < 0.05) for five PS key dimensions: ' Error reporting confidence ', ' Working hours as a cause of error ', ' Professional incompetence as a cause of error ', ' Team functioning ' and 'PS training received'. Tunisian medical students showed positive attitude towards PS. Nevermore, intensive in terms of frequency and duration sessions, based on various teaching methods may be needed to fulfill students' educational needs.